厦门市18岁及以上人群精神障碍现况调查

Epidemiological survey of mental disorders in people aged 18 years and older in Xiamen city

目的了解厦门市年龄≥18岁人群各类精神障碍的患病率及分布特点。方法采用多阶段分层整群抽样方法随机抽取厦门市12071名年龄≥18岁人群为调查对象，用扩展的一般健康问卷（GHQ．12）进行筛查，将调查对象分为精神障碍高危、中危、低危，然后使用《美国精神障碍诊断与统计手册（第4版）轴I障碍定式临床检查（患者版）》（SCID—I／P）依次对100％高危险人群、40％中危险人群和10％低危险人群进行调查，作出有无精神障碍及具体诊断。结果共10764名完成调查，完成率为89．17％。精神障碍总现患率（最近1个月）为3．46％[95％可信区间（CI）：3．13％-3．82％]，总终生患病率为6．35％（95％CI：5．90％～6．83％）。按照现患率高低排列，前5位的单病种精神障碍为重性抑郁障碍（0．83％）、心境恶劣障碍（0．55％）、未特定焦虑障碍（0．51％）、未特定抑郁障碍（0．44％）、精神发育迟滞（0．40％）。总现患率农村（5．99％）高于城镇（2．79％），本地户籍（4．19％）高于外地户籍（2．21％），年龄40～54岁（4．55％）和≥55岁人群（5．05％）均高于18～39岁人群（2．30％），差异均有统计学意义。在有精神障碍且有相关资料的226例患者中，功能损害程度为中等到严重者69例，占30．53％，仅21例因心理问题求助过心理卫生专业机构，占9．30％。结论重性抑郁障碍、心境恶劣障碍、未特定焦虑障碍、未特定抑郁障碍、精神发育迟滞是厦门市最常见精神疾病；农村、年龄／〉55岁人群和本地户籍人群患病率较高。

Objective To describe the prevalence and distribution of all type of mental disorders among people aged 18 years and older in Xiamen City. Methods Using multi-stage stratified cluster sampling, 12 071 subjects aged 18 years and older were identified in Xiamen City. The subjects were sereed with the expanded version of GHQ-12 and classified as high, moderate or low risk of having a mental disorder based on the results. Different proportions of the three groups （100% of the high-, 40% of the moderate-, 10% of the low-risk） were assessed with the Structured Clinical Interview for DSM-1V-TR, and made a determintation that whether they had mental disorder and specific diagnosis. Results A total of 10 764 subjects completed the screening, the completion was 89. 17%. The 1-month overall prevalence of any mental disorder was 3.46% （95% CI： 3.13% - 3.82% ） , and the overall lifetime prevalence was 6. 35% （95% CI：5.90% -6. 83% ）. The prevalence rates of single disorders were as following： major depressive disorder （0.83%） , dysthymic disorder （0. 55% ） , anxiety disorder NOS （0.51%） , mood disorder NOS （0. 44% ）, mental retardation （0. 40% ）. The prevalence was higher in rural than in urban （5. 99% vs. 2. 79% ） people, higher in Xiamen household register than non-Xiamen household register （4. 19% vs. 2. 21% ）. higher in ones aged 40 -54 years （4. 55% ） and aged 55 years and older （5.05%） than ones aged 18 -39 years （2. 30% ）. Among 226 subjects with a disorder, 30. 53% were moderately to severely affected due to the disorder, but only 9.30% had ever received any type of mental health treatment. Conclusions Major depressive disorder, dysthymic disorder, non-specific anxiety disorder, non- specific mood disorder and mental retardation are the most mommon mental disorders in Xiamen. Persons in rural or ones aged 55 years and older or household register have higher prevalence rate.